A New Sweet Potato for an Old Problem: An Education Curriculum to Increase the Nutrition Benefits of An Agriculture Project Promoting Orange Fleshed Sweet Potato in Ethiopia Öffentlichkeit

Abstract

Background: Chronic undernutrition and micronutrient deficiencies have serious lifelong consequences for young children. In Ethiopia, 38% of children are stunted, a reflection of chronic undernourishment and an estimated 38% of the population has subclinical vitamin A deficiency. The first 1,000 days—the period from conception to a child’s second birthday—are crucial for growth and development; consequences of undernutrition during this period are largely irreversible. Much of this window of opportunity encompasses the period of complementary feeding (6-24 months) making it imperative that nutrition interventions focus on this period. Nutrition-sensitive agriculture, and in particular orange-fleshed sweet potato (OFSP) interventions have great potential to improve child health outcomes.

The Project: The Quality Diets for Better Health project is a four-year nutrition sensitive agriculture project that seeks to introduce a reliable, bioavailable source of vitamin A and energy into the food supply to improve the quality of diets of young children and their families. Groups of 30 households will come together to form Healthy Living Clubs (HLCs), around which dissemination of OFSP planting material, training in OFSP farming and nutrition education will be organized.

Methods: Qualitative formative research to identify barriers and facilitators to optimal infant and young child feeding practices was conducted to inform the design of this curriculum. Additionally, a social and behavior change communication strategy was developed.

Curriculum: The final product of this special studies project is a nine-session participatory nutrition education curriculum focusing on maternal nutrition, complementary feeding, and incorporating orange-fleshed sweet potatoes into families’ diets. Each session includes a review of the previous session, a discussion of goals attempted over the previous month, an interactive activity, and goal setting for the subsequent month.

Conclusion: Complementary feeding (CF) is a series of complex behaviors that exist within a web of societal structures, environments and cultures. This CF curriculum, embedded within a nutrition sensitive OFSP project, addresses knowledge, skills and opportunity through the introduction of a bioavailable source of vitamin A, to improve CF practices in rural, southern Ethiopia. Reducing stunting and the burden of undernutrition require investments in CF behavior change interventions that address the multitude of factors that influence CF.

Table of Contents

Table of Contents

 Chapter I: Introduction – 1

List of Definitions and Abbreviations – 3

Chapter II: Comprehensive Literature Review – 4

Undernutrition & Stunting: Causes and Consequences – 4

Complementary Feeding (CF) – 6

Table 1: Guiding Principles for Infant and Young Child Feeding – 7

Vitamin A – 8

Orange Fleshed Sweet Potatoes (OFSP) & Nutrition Sensitive Agriculture – 10

Community Nutrition Education – 13

Social & Behavior Change Communication – 15

Adult Learning Theory – 18

The Quality Diets for Better Health (QDBH) Project – 19

Chapter III: Methods – 22

Table 2: Desired Changes by Audience Segment – 24

Chapter IV: Results – 27

Table 3: HLC Session Topics – 29

Table 4: HLC Activities and Tools Descriptions – 31

Table 5: Activities & Tools used in HLCs and Associated Behavior Change Techniques, Theoretical Domain Frameworks, and COM-B Domains – 32

Chapter V: Discussion, Recommendations and Conclusion – 33

Discussion – 33

Recommendations – 36

Table 6: Potential Reporting Requirements for Behavior Change Interventions – 36

Conclusion – 38

References – 40

Appendix 1: Healthy Living Club Curriculum – 44

Appendix 2: HDA Session Guides – 96

Appendix 3: Sample Monitoring Tool – 111

Appendix 4: Pictorial HLC Tools – 114

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Agriculture, General Health Sciences, Nutrition
Stichwort	Complementary Feeding Nutrition Sensitive Agriculture Child Nutrition
Committee Chair / Thesis Advisor	Webb-Girard, Amy, Emory University
Partnering Agencies	International Non-governmental organization (e.g., CARE, Inc.)

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